Aside

Contact Info

Skills

Experienced in statistical analysis, predictive modeling, healthcare analytics, financial forecasting and budgeting.

Lanuagues

End-to-End R Skills

Statistics

Main

Brian Muir, PhD

Highly-inquisitive team-leader with 11+ years of experience employing machine learning and statistics in the healthcare industry and in computational biology. Direct the forecasting of $10+ billion in pharmacy and medical claim expenses using advanced predictive models in R for Centene Corporation’s (Fortune 500) marketplace insurance LOB.

Education

University of California Riverside

Ph.D. in Evolution, Ecology & Organismal Biology

Riverside, CA

2016 - 2010

Boston College

B.S. in Biology, Psychology (Double Major)

Chestnut Hill, MA

2010 - 2006

Professional Experience

Director - Marketplace Forecasting

Centene Corporation / Actuarial Services

Chicago, IL

Current - Jul, 2018

  • Direct the development, implementation, and presentation of the financial forecast for medical expenses expenses across 26 state products using mixed-models regression.
  • Lead a team of six actuaries and data analysts working on a wide range of analytics projects encompassing: interactive claims dashboards using Rshiny and RMarkdown, advanced forecasting methods, SQL database creation and maintenance, and ad-hoc deep dive analyses for multiple business partners across Actuarial, Finance, Sales, Product, Policy, Medical Management, Pharmacy, and Marketing.
  • Present findings to leadership on member-segmented variances to forecast, financial impacts of COVID cost and deferral of services, and deep-dives into claims trends during monthly CFO financial briefings.
  • Developed a member-level gross margin database detailing revenue and expense components across 40 targetable member characteristics that integrates disparate data sources using SQL/R. Deployed overlaying drill-down dashboard in RSConnect used widely across departments to identify risks and opportunities for member-segmented business actions.
  • Identified an $8M annual initiative to improve on risk adjustment code capture of Hemophilia that we continue to support with outreach targets via an in-production Shiny Dashboard.
  • Created stratified med-management model based on interacting the two dimensions of utilization and health status to highlight top conditions, disease management status/acceptance, risk score, risk adjustment code capture opportunity, claim costs and demographics by segment to identify optimal cohorts for med management programs.

Data Scientist I

Centene Corporation / Actuarial Services

Chicago, IL

Jul 2018- Sep 2016

  • Built and implemented a novel claims completion model using regression to estimate incurred but not reported expenses prior to month end; an advance over traditional methods to accelerate preparation of financial reporting and commentary.
  • Developed a claims outlier detection model by Episode Treatment Group to direct investigations into abnormal claim areas each month.
  • Designed primary care auto-assignment algorithm to optimally assign members to high-quality, low-cost providers.
  • Devised Rx Trends and Top Conditions interactive RMarkdown dashboards to highlight emerging trends in Rx utilization; present findings monthly during Rx Governance Committee meetings.

Research Experience

Graduate Research Assistant

University of California Riverside

Riverside, CA

2010 - 2016

  • Analyzed large gene expression datasets with R (Bioconductor) using non-parametric statistical models.
  • Performed statistical tests of codon evolution in cancer gene-sequence alignments using maximum likelihood models.
  • Designed and directed multi-year longitudinal experimental evolution study on fruit flies overseeing 2 – 6 undergraduate volunteer research assistants per quarter. Employed advanced experimental design statistics.
  • Taught 18 quarters of upper and lower division biology courses with up to 150 students per week. Mentored 2 – 6 undergraduate volunteer research assistants per quarter.

Publications and Presentations

The expression of tumour suppressors and proto-oncogenes in tissues susceptible to their hereditary cancers.

Muir, B. & Nunney, L. British journal of cancer, 113(2), 345-353.

N/A

2015

Peto’s paradox and the hallmarks of cancer: constructing an evolutionary framework for understanding the incidence of cancer.

Nunney, L. & Muir, B. Phil. Trans. R. Soc. B, 370(1673), 20150161.

N/A

2015

Presentations

  • International Biannual Evolution and Cancer Conference - Lightning Talk & Poster | 2015
  • Evolution Conference - Talk | 2014

Exams

Society of Actuaries Exams

  • PA - Predictive Analytics | Jun 2019
  • SRM - Statistics for Risk Modeling | Jan 2019
  • P - Probability | Sep 2018